here is a little video I made to help those struggling with Schizophrenia! I hope it helps!! This is ALL hy info from Rx, and nuances that may have not been mentioned or talked about much.Bit By Bit MD
NBME and Step; notorious for their long vignettes (esp the latter) and wording that throws even the brightest soul off. Through my time studying for these exams, relentlessly taking the forms and going over all the PQ's, I realized often times, it was not my content that was the hindrance.....Rather, it was my test taking ability. So as any reasonable, high functioning, ADHD prone med student would do... I MADE A GUIDE! The number one killer of morale and scores is not your material, its your mindset. Learning how to break down every question,teaching yourself slowly but surely, that you are learning to think like the test taker, is imperative for success not only for Step 1, but also shelfs.
Hi all!! If anyone is looking for help with step1/nbme and/or wants scheduling/time management help, let me know!
Got my result back. Passed, alhamdulillah. I lurked this sub a lot during prep so figured I'd write up what actually worked and what I'd do differently. This isn't a "use X resource and you're golden" post. I tried a lot of things. Some worked really well. Some were a waste of energy.
I started in the low 60s and that felt brutal for weeks. The jump from 65 to 73 on NBME 25 was the first real signal something was clicking. After that the trend held. The 78 on NBME 31 spooked me, but the next two came back as 85 and 89, so I just kept moving.
1. I treated UWorld like a textbook, not a question bank. Every block was the same loop:
That review process was where most of my real learning came from. The score on the block doesn't matter if you don't extract every teaching point out of it.
2. NBMEs were my reality checks. I used them to identify weak systems, track real improvement, and learn how the questions are written. The biggest mistake people make with NBMEs is using them just for the score. I reviewed mine hard, every single one. That's where the patterns clicked. UWorld percent correct is noise. NBMEs are the truth.
3. Pathoma carried my foundation. If something didn't make sense, Pathoma usually fixed it. I didn't try to memorize it like a robot. I focused on understanding mechanisms and linking them back to questions. Once you really get pathology mechanisms, half the test is just pattern recognition.
4. Layering resources, not stacking them randomly. I didn't run everything at once. I used:
These were support tools. UWorld and NBMEs were the main system.
5. Volume of questions, daily. At my peak I was doing 120 to 200 questions a day in 4 blocks of 40 to 50. It sounds insane and it kind of was. But it built the test stamina that actually shows up on test day. You're not just learning content, you're training your brain to stay sharp through 7 hours.
6. Hitting weak systems hard. Neuro and MSK were my graveyard. I built a 100-topic neuro master table and ground extra MSK blocks until they stopped feeling alien. They still weren't my strongest on test day, but they weren't disasters either.
7. I built my own materials. This isn't for everyone but it was huge for me. I made an 11-part Clinical Mastery PDF series across all the major systems, vignette-first, mechanism-based, with a trap analysis section for each topic. I also turned a bunch of Mehlman PDFs and the Free 120 into interactive HTML quizzes I could grind through. Building these probably taught me as much as using them did.
8. Consistency over intensity. I had days where I pushed 12 hours. But what mattered more was showing up daily. Even on bad days I still did something. That's what kept momentum alive.
1. Less passive First Aid early on. I burned maybe 3 weeks just reading and highlighting before I started doing questions. That time would have been gold if I'd been doing UWorld blocks alongside it. Active recall from day one.
2. Don't bail mid-test like I did on NBME 26. This is the one I want to drill in. The anxiety can be worse than the test itself. Bailing out mid-form is a habit you want to break before you ever sit for the real exam. Finish the form even if you're spiraling. The score doesn't matter as much as the practice of pushing through a block when your brain is screaming at you. Test day isn't going to be kind to people who walk away from bad blocks.
3. Trust your data. My scores clearly showed I was in the safe zone well before test day, but I kept second-guessing myself anyway. Once you are consistently hitting the high 70s and 80s on NBMEs, trust the system you built. The doubt is not new information.
4. Don't overload your days. Trying to do 3 UWorld blocks plus full reviews plus Pathoma plus videos in one day sounds productive. It is not sustainable. If I could redo it, I'd prioritize depth over volume. 2 solid blocks plus a deep review beats 3 rushed blocks every time.
5. Manage your energy. Some days I was locked in. Other days I crashed hard. Too much caffeine, inconsistent sleep, pushing through burnout, all of it catches up. If your brain is fried, you're not learning. You're just going through the motions.
6. Master high yield instead of "covering everything". There's a point where adding more resources stops helping. If I could redo it I'd double down on repeating high-yield concepts instead of constantly chasing new material. The goal is mastery of the core, not exposure to everything.
This exam is not just knowledge. It's control. There were days where focus wasn't there, motivation dropped, and doubt kicked in. What helped me push through wasn't hype or willpower. It was grounding myself, staying disciplined, and remembering there's a higher purpose behind what I'm doing. Staying connected to that kept me steady when everything else felt off.
If you're religious, lean into it. If you're not, find your version of it. Hype days don't get you through 6 months of this. Discipline does.
You don't need 10 resources. You don't need a "perfect" schedule. You need:
That's really it.
If you're in the middle of prep right now, just know: it's supposed to feel uncomfortable. That doesn't mean you're failing. It usually means you're doing it right. Your low NBMEs are not your final score. Mine started at 60. I passed.
For anyone at a Caribbean school like me, the bar and the timeline are real. Don't let anyone tell you your prep needs to look different just because of where you went. The test doesn't care.
If anyone has questions or wants me to look at their prep plan, drop a comment. I got you.